If you experience pain in the upper, lower, or mid-tummy, which is changed by passing a bowel motion or eating and predominately occurring during the day, it may be originating from your gut.

Pain and discomfort can be caused by:

• Food allergies or intolerances
• Bacterial infection (Helicobacter Pylori)
• Inflammation
• Small Intestinal Bacterial Overgrowth (SIBO)
• Gastritis
• Crohn’s Disease or Ulcerative Colitis
• Irritable Bowel Syndrome
• Peptic ulcer
• Diverticulitis
• Organ distention or stretching
• Urinary tract infection (UTI)

*Seek urgent medical attention if your pain has come on suddenly, is progressive or relentless, and is associated with:

• Fever
• Pain during movement
• Vomiting or vomiting blood
• Bloody stool
• Difficulty breathing
• Pregnancy

Reflux is where stomach acid comes up from the stomach into the esophagus. This occurs when the lower sphincter muscle relaxes, causing stomach acid and digestive enzymes to splash back up, leaving a burning sensation in the throat. The lower sphincter muscle is triggered by hydrochloric acid, also known as HCL. Low stomach acid causes the sphincter to stay open, allowing acid to splash back up. Acidity levels are measured on what’s known as a pH scale from 1 to 14, with 1 being the most acidic, and 8 or above being alkaline.  With stomach acid being low, or too alkaline, food is not digested properly or nutrients absorbed. This leads to indigestion, malnutrition, and bacterial overgrowth. If left untreated reflux can go on to cause ulceration, bleeding, stricture, and cancer.

Reflux can be caused by:

• Deficiency of stomach acid (known as Hypochlorhydria)
• Helicobacter Pylori
• Stress
• Gastroesophageal Reflux Disease (GERD)
• Esophageal sphincter dysfunction 
• Chronic low-grade inflammation
• Hiatal hernia
• Obesity
• Pregnancy
• Anti-inflammatory medications

Common symptoms:

• Sore throat or an irritated feeling in your esophagus
• Heartburn
• Bad breath
• Chest pain
• Regurgitating your stomach’s contents
• Nausea and vomiting
• Difficulty swallowing

Bloating is a buildup of gas in the stomach and intestines. Gas is produced as your body breaks down food. It leaves you feeling full, and gassy and you may experience abdominal discomfort. Certain foods can cause more gas than others. Some people produce more gas than normal and experience intolerable and painful symptoms. 

Bloating can be caused by:

• Gas
• Constipation
• A gastrointestinal infection or blockage
• Irritable Bowel Syndrome (IBS)
• Coeliac disease
• Food intolerances
• Digestive enzyme deficiency
• Anxiety and stress
• Helicobacter Pylori 

Coeliac disease is an autoimmune disorder where an immune reaction is triggered by consuming gluten (a protein found in wheat, rye, and barley).  This leads to inflammation in the small intestine and the intestine’s lining becomes damaged.  Over time the damage prevents nutrients from being properly absorbed into the body.  This can lead to deficiencies in vitamins and minerals. Coeliac disease is not a food intolerance but an allergic reaction.  There are potential serious health consequences of undiagnosed or untreated coeliac disease. This can be tested either through a small bowel biopsy during a gastroscopy, or a blood test called the transglutaminase antibodies.

Common symptoms are:

• Diarrhoea and/or constipation
• Flatulence
• Abdominal pain, cramping or bloating
• Indigestion
• Vitamin deficiency in iron (anemia), vitamin B12, or folic acid
• Fatigue
• Unexpected weight loss
• Hair loss
• Mouth ulcers, and dental problems
• Liver abnormalities
• Numbness and tingling in the hands and feet

Constipation is a condition where you develop infrequent bowel movements (less than three per week) and when you do have a movement it is dry, knobbly and painful. Lifestyle and diet is normally the cause of constipation, but there are some diseases which cause the gut to move slowly causing a back log in the bowel.

Less serious causes of constipation:

• Dehydration
• Lack of dietary fibre
• Diets that are too high in fat, sugar, alcohol or caffeine
• Physical inactivity
• Medication side effects

Disorders that cause constipation:

• Helicobacter Pylori 
• Irritable Bowel
• Stroke
• Parkinson’s
• Diabetes
• Lupus
• Bowel Cancer

Crohn’s is a type of chronic inflammatory bowel disease that affects the lining of the digestive tract. The body produces an immune response that incorrectly attacks the digestive tract causing the lining to thicken, become inflamed and damaged. Some people experience severe chronic symptoms that never go away, and others may have periods of good health followed by a flare up. Patients may need to receive regular screening for colorectal cancer due to increased risk.

Common symptoms are: 

• Abdominal pain
• Diarrhoea and/or constipation
• Sensation of incomplete bowel movement
• Urgent need to move bowels
• Bleeding from the bowel
• Fever
• Unexplained weight loss
• Malnutrition
• Eye inflammation
• Fatigue
• Anaemia
• Abnormal pain
• Skin rashes

Diarrhea is a common condition where your bowel motions are loose and watery.  You may also experience some urgency to go to the toilet and need to go more often. Symptoms usually last a few days and then clear up by itself, but if it continues to last for more than a week then it may indicate a more serious underlying problem. 

Common causes for short-term diarrhea:

• Stomach bug
• Consuming too much rich food or alcohol
• Stress

Common causes for long-term diarrhea:

• Food intolerance/allergies
• Inflammatory Bowel Disease
• Coeliac Disease
• Irritable Bowel Syndrome (IBS)
• Polyps
• Overactive thyroid
• Changes in diet
• Bowel Cancer

Diverticulosis is the presence of small bulging pouches that form in the bowel wall. Diverticulums usually develop when naturally weak places in your colon give way under pressure. Constipation and straining to pass a bowel motion raise the pressure inside the colon, forcing pouches through points of weakness in the bowel wall. A diet low in fiber and high in red meat may be a common cause. 

Diverticulitis occurs when one or more pouches tear and become inflamed or infected. 

A diverticular abscess occurs when a collection of pus next to the bowel forms from an infected diverticulum. Symptoms include pain and fever.  Treatment is with antibiotics.  Sometimes the abscess must be drained by an x-ray-guided procedure or an operation. 

Peritonitis occurs when a diverticulum bursts causing bowel contents to leak into the abdomen.  Symptoms are severe, generalized abdominal pain.  An urgent operation is usually required.

Common symptoms of diverticulosis:

• Change in bowel habits (alternating constipation and diarrhea)
• Abdominal pain

Fatty liver occurs when the liver does not process and break down fats as it normally should, causing the cells of the liver to develop and build up fat. The liver is responsible for processing and filtering what we eat and drink. Too much fat can interrupt the filtering process of the liver. If 5-10% of your liver is fat then fatty liver disease is diagnosed through a blood test, an ultrasound and finally a liver biopsy.  It is generally a benign condition, but in a minority of patients, it can progress to liver failure (cirrhosis).

Common symptoms are:

• Abdominal pain (in the central or upper right stomach)
• Low appetite
• Weight loss
• Fatigue
• Some confusion or difficulty concentrating
• Nausea
• Swelling in the liver region

• Alcohol (symptoms may worsen after alcohol consumption) *Fatty liver may be present in non alcohol consumers
• Eating excess calories
• Obesity
• Diabetes
• High triglycerides
• Rapid weight loss
• Other liver diseases
• Certain medications
• Hereditary

The term “food hypersensitivity” refers to both food allergies and food intolerances. A food allergy is a serious condition where the body thinks that certain food is an invader and has an immediate, sometimes life threatening immune reaction to it. 

A food intolerance is where our bodies struggle to digest certain types of food.  The gut is unable to break down the food easily and creates a gas in the stomach.  This leads to very painful symptoms which can have a serious impact on your general health and wellbeing. Food intolerances are common but food allergies are rare. 

Common symptoms are: 

• Abdominal pain
• Diarrhea
• Bloating
• Nausea
• Indigestion
• Reflux
• Eczema
• Increased asthma
• Headaches
• Fatigue

The main group of food that people are intolerant to are called FODMAPS. This includes:

• Lactose (e.g dairy)
• Fructose (e.g apples, pears, honey)
• Fructans (e.g gluten, onions)
• Galactans (e.g legumes, cabbage)
• Polyols (e.g. stone fruits, mushrooms)

Other common food intolerances are:

• Eggs
• Yeast
• Caffein
• Sulfites (preservatives) 
• Aspartame
• MSG
• Food colorings
• Sugar alcohols
• Amines (produced by bacteria during food storage and fermentation)
• Salicylates (natural chemicals produced by plants)

Haemorrhoids are swollen and inflamed blood vessels in the rectum and anus that cause discomfort. The lining of the swollen vein can become irritated and bleed during the straining and pressure caused by a bowel movement.

An internal haemorrhoid may protrude outside the anal sphincter. They contain pain-sensing nerves and can therefore be painful.  They usually go back into the rectum on their own, or can gently be pushed back into place.

External haemorrhoids are found within the anus. Blood clots can form within protruding external haemorrhoids, causing a very painful condition called a thrombosis.  The haemorrhoid can turn purple or blue, and possibly bleed.  This condition is not usually serious and may disappears within a couple of weeks, or removed by a specialist it if the pain is unbearable.

Common causes are:

• Obesity
• Pregnancy
• Standing or sitting for long periods
• Straining during bowel movements
• Coughing
• Sneezing
• Vomiting

Heartburn is an uncomfortable burning sensation in the chest, usually experienced after eating, and may worsen when lying down. Heartburn may be diagnosed through a gastroscopy, pH Impedance test and BRAVO test. 

Common causes of heartburn are:

• Reflux
• Stress or anxiety
• Eating too much or too quickly
• Fatty, greasy, or spicy foods
• Too much caffeine, alcohol, chocolate, or carbonated drinks
• Taking over-the-counter medications (i.e ibuprofen or aspirin)
• Helicobacter pylori
• Stomach ulcers
• Weight Gain

More serious causes:

• Cancer
• Heart disease

Persistent heartburn can damage your esophagus and may cause inflammation, bleeding, or difficulty swallowing. If you experience regular heartburn, it’s important to seek medical treatment.

A hiatal hernia is a condition in which part of the stomach pushes up through the diaphragm muscle. Your diaphragm is the muscle barrier that separates your abdominal cavity from your chest cavity. Sliding hiatal hernias are the most common types of hernias. Stress and strain can widen this opening over time. This condition usually develops slowly over many years and some people don’t experience any symptoms at all. 

Hiatal hernias may cause acid reflux. This occurs when the gastroesophageal junction rises above your diaphragm and pulls some of the muscles that would normally contract to prevent acid reflux. When these muscles can’t tighten enough to close your esophagus effectively, stomach acid can splash back into it. The hernia also traps a pocket of acid at the top of your stomach that can’t clear away. An esophageal pH test can be done to confirm the presence of acid in the esophagus. Hiatal hernias are diagnosed through a chest x-ray, esophagram, upper endoscopy, or esophageal manometry.

The most common symptoms are related to GERD. These include:

• Heartburn
• Acid reflux
• Noncardiac chest pain
• Indigestion
• Abdominal pain
• Burping and regurgitation
• Difficulty swallowing
• Sore throat and hoarseness

 Causes of hiatal hernias are:

• Chronic stress 
• Chronic coughing or sneezing
• Chronic constipation
• Chronic obesity (BMI, or body mass index, greater than 30)
• Frequent vomiting
• Intense exercise or heavy lifting
• Pregnancy and childbirth

• Esophagitis
• Esophageal stricture
• Barrett’s esophagus
• Gastrointestinal obstruction
• Gastritis
• Ischemia
• Stomach ulcersHiatial hernias a

Histamine intolerance is not a sensitivity to histamine but an indication that you have developed too much of it. It’s a chemical in the body that plays a role in the immune, digestive and nervous systems. It helps protect the body from infection, it triggers the release of stomach acid to help digestion and it sends messages to the brain. 

Some people are not able to properly break down histamine due to an impaired function of the N-methyltransferase and diamine oxidase (DAO) enzymes. These enzymes are responsible for breaking down histamine, and if not broken down efficiently, it can lead to a build up.  Histamine receptors are located throughout your body, therefore a build up can impact several bodily functions.

• Genetics
• Certain medications that temporarily block DAO functions
• Gastrointestinal (GI) disorders
• Diet high in histamine-rich foods 
• Bacterial overgrowth

Common symptoms are:

• Abdominal pain
• Digestive issues
• Flatulence
• Bloating
• Diarrhea
• Constipation
• Flushing of the skin
• Headaches
• Nausea
• Hives
• Itching
• Anxiety
• Irregular menstrual cycle
• Fatigue
• Dizziness
• Low blood pressure
• Difficulty regulating body temperature

Diseases that may cause histamine intolerance:

IBS is an intestinal disorder characterized by a change in bowel habits, abdominal pain and discomfort. This occurs when the muscles of the intestine don’t contract when food is passing along the colon, resulting in food moving too quickly or too slowly through the intestine. The cause of IBS is still unknown, but it may be triggered by an infection or inflammation of the gut or by injury to the gut. If the gut is irritated then a vicious cycle of gut irritation occurs.

The term “syndrome” refers to a cluster of chronic symptoms experienced. IBS is also known as spastic colon, irritable colon, mucous colitis, and spastic colitis and isn’t related to other bowel conditions. IBS doesn’t increase your risk of gastrointestinal cancers, but it can have a significant effect on your life. The condition is most common among women and young people. 

Common symptoms of IBS are:

• Abdominal cramps
• Diarrhoea and/or constipation
• Bloating
• Gas
• Mucus present in the stool